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目的分析2009-2016年天津市85家动物致伤处置门诊暴露人群流行病学特征及暴露后处置情况,为狂犬病防控提供科学依据。方法收集天津市动物致伤处置门诊报告的人群资料及狂犬病病例资料,采用Excel 2007软件进行数据录入,SPSS 22.0软件进行率的χ~2检验及Mann-kendall趋势检验。结果天津市2009-2016年累计接诊636 286人次,年平均暴露率为558.20/10万,不同年度暴露率差异有统计学意义(χ~2=9 016.882,P=0.000),其中Ⅲ级伤口暴露率呈上升趋势(Z=2.230,P<0.05)。暴露人群分布呈现明显季节性,5-8月累计暴露人数占全部暴露人数的43.50%。男性暴露率高于女性(χ~2=223.512,P=0.000),0～14岁年龄组人群暴露率为117.13/10万,远高于其他年龄组。犬暴露占82.28%,70.67%的伤口为Ⅱ级暴露,52.35%的暴露部位为上肢。门诊伤口处置率为86.60%。疫苗接种率为99.80%,Ⅲ级暴露人群被动免疫制剂接种率有上升趋势(Z=2.969,P<0.05),但总体接种率仅为31.48%。结论应依托规范化动物致伤门诊建设进一步规范门诊处置,同时加强狂犬病防治宣传,特别是针对重点地区重点人群进行健康教育。
OBJECTIVE: To analyze the epidemiological characteristics and post-exposure disposal of 85 outpatients exposed to animal injuries from 2009 to 2016 in Tianjin and provide a scientific basis for the prevention and control of rabies. Methods The data of the outpatients in animal injury treatment and the rabies cases in Tianjin were collected. The data were imported by Excel 2007 software and the χ ~ 2 test and Mann-kendall trend test of SPSS 22.0 software were performed. Results In 2009-2016, Tianjin had a total of 636 286 visits, with an average annual exposure rate of 558.20 / 100 000. There was significant difference in the annual exposure rates (χ ~ 2 = 9 016.882, P = 0.000) The exposure rate showed an upward trend (Z = 2.230, P <0.05). The distribution of exposed population showed a clear seasonal distribution, with the cumulative exposure in May-August accounting for 43.50% of the total exposed population. The exposure rate of males was higher than that of females (χ ~ 2 = 223.512, P = 0.000). The population exposure rate of 0 ~ 14 age group was 117.13 / 100,000, much higher than other age groups. Dog exposure accounted for 82.28%, 70.67% of the wounds were grade Ⅱ exposure, 52.35% of the exposed parts of the upper limbs. Outpatient wound treatment rate was 86.60%. The vaccination rate was 99.80%. The immunization rate of passive immunization patients in Ⅲ level exposed population showed an upward trend (Z = 2.969, P <0.05), but the overall vaccination rate was only 31.48%. Conclusion It is necessary to standardize the construction of animal injury clinics to further standardize out-patient treatment, while strengthening the prevention and treatment of rabies publicity, especially for key populations in key areas for health education.